Loss of Self-Awareness Due to PTSD

Psychological trauma exerts emotional and also physical consequences on sufferers. But, why do they lose their self-awareness? Find out here.
Loss of Self-Awareness Due to PTSD
Gorka Jiménez Pajares

Written and verified by the psychologist Gorka Jiménez Pajares.

Last update: 03 April, 2024

Trauma has the potential to hijack the brain. In fact, in the aftermath of the horror of the situations that trauma sufferers experience, their bodies cease to belong to them. In effect, they experience a loss of bodily self-awareness. Consequently, their bodies activate at the slightest hint of danger. This prevents them from ‘being themselves’ as their physical symptoms take over.

Many brain areas participate in this ‘corporal hijacking’. However, the most important is probably the amygdala. This structure is common to all mammals. It’s the region that allows us to feel and, above all, to survive.

“Trauma makes us feel disconnected from our bodies, from others, and from the world, and healing involves reconnecting those parts.”

-Bessel van der Kolk-

The kidnapping of the body

When an individual perceives danger with the potential to threaten their survival, it only takes a few seconds for their brain to adopt the fight, flight, or freeze response. In effect, they lack the capacity to evaluate and interpret if the situation is really dangerous or harmless.

This occurs in post-traumatic stress disorder (PTSD). As a result of the pain, anger, helplessness, and terror that the individual experiences, the stimuli that occurred while the traumatic event lasted become associated with the emotion of fear.

This explains how survivors of traumatic events are terrified by many different stimuli that don’t tend to cause fear in the general population. For example, Mark, a survivor of the war in Iran, panics every time he hears the blades of an air fan, because they remind him of the movement of the blades of his combat helicopter in which all his companions died.

This means the most trivial and harmless stimulus can be capable of capturing and ‘kidnapping’ an individual. They experience symptoms such as tachycardia and panic attacks. They also feel fear, anguish, and anxiety. In effect, it becomes a cocktail that ends up paralyzing them. The area responsible for this hijacking is the amygdala.

“The body is the basis of the Self and has the experience, and anything that ignores the experience of the body has terrible therapeutic consequences.”

-Bessel van der Kolk-

Woman with post traumatic stress disorder sitting on the floor
Anguish and fear are consequences of psychological trauma. They lead to a loss of bodily self-awareness.

Self-awareness: key to recovery from PTSD

While the amygdala is responsible for capturing the individual and dragging them into a chaotic and gloomy emotional universe, the medial prefrontal cortex contributes reason. I fact, it’s the seat of self-awareness (Van der Kolk, 2020).

Being self-aware means knowing what’s happening in your body. It’s a sense of interoception. Van der Kolk is one of the most famous psychiatrists in the world in relation to psychological trauma. He claims that, within the treatment of PTSD, two questions must be asked:

  • What do you experience?
  • What happens afterward?

Individuals suffering from trauma go through their lives with burning emotions. Moreover, they often experience frustration, anger, terror, or anguish in bodily ways. They frequently experience these feelings in their chests and stomachs.

“Body self-awareness puts us in touch with our inner world; the landscape of our organism.”

-Bessel van der Kolk-

Loss of self-awareness and the fear of emotion

Avoiding contact with these feelings is counterproductive because it increases them. However, with the two questions Van der Kolk suggests, the individual connects with their emotions. Consequently, this promotes, as opposed to reduces self-awareness.

PTSD is seen as a ‘hostile adversary and rival’. That said, it isn’t the aggressor in itself. The bodily sensations and emotions that the individual experiences are. Van der Kolk states: “The fear of being hijacked by unpleasant sensations causes the body to freeze and the mind to shut down.” For this reason, it’s essential that the sufferer changes the way in which they relate to themselves and their body.

Anyone who attends therapy must be aware that both their emotions and their bodily sensations have a definite beginning, but also an end. In fact, this perception of ‘impermanence’ can be a useful strategy in tolerating the negative impact of anxiety and terror.

Man receives support for psychological trauma
It’s essential to name emotions to learn to treat them.

Naming emotions

The next step is to label, name, and assign a description to the individual’s feelings. As such, the sufferer must give narrative meaning to their emotions. This activates their medial prefrontal cortex, as opposed to hyperactivating the amygdala. It makes use of reason to balance emotion.

After a traumatic event, there may be a multitude of stimuli that remain associated with the ‘danger’ message. In the months to come, these stimuli have the potential to unleash waves of emotions that paralyze the trauma sufferer. This occurs because the amygdala is the emotional center of the brain that ‘abducts’ us in order for us to survive.

However, the stimuli that were associated with the trauma at the time are harmless today. Yet, they continue to ‘kidnap’ the sufferer. For this reason, the sufferer must increase their self-awareness. The aim is to promote less aversive and more friendly reactions to stimuli.

“Focus on that feeling and see how it changes when you take a deep breath, or when you hit your chest just below the collarbone, or when you allow yourself to cry.”

-Bessel van der Kolk-

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Van der Kolk, B. A., & Van der Kolk, B. A. (2020). El Cuerpo Lleva la Cuenta: Cerebro, Mente Y Cuerpo en la Superación Del Trauma. Alianza Editorial.
  • Belloch, A. (2020). Manual de psicopatología, vol II.
  • American Psychiatric Association. (2014). DSM-5. Guía de consulta de los criterios diagnósticos del DSM-5: DSM-5®. Spanish Edition of the Desk Reference to the Diagnostic Criteria From DSM-5® (1.a ed.). Editorial Médica Panamericana.
  • Seijas Gómez, R. (2019). Aspectos neurobiológicos y neuropsicológicos del trastorno por estrés postraumático. Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace, 2013, num. 104, p. 19-28.
  • Seijas Gómez, R. (2013). Trastorno por estrés postraumático y cerebro. Revista de la Asociación Española de Neuropsiquiatría, 33(119), 511-523.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.